Service Assurance Analyst

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🕒 July 7

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Unimed Nacional

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1998

⚕️ Healthcare Insurance

👥 B2C

🤝 Non-profit

Healthcare Insurance • B2C • Non-profit

Unimed Nacional is an organization that provides various healthcare services and benefits for its members, aiming to enhance access to medical care in Brazil. It operates within a network of healthcare professionals and facilities to offer comprehensive health solutions to individuals and families.

📋 Description

• Receive, monitor, triage, and respond to internal and external reports related to network unavailability, ensuring strict compliance with regulatory deadlines (ANS - Brazilian National Supplementary Health Agency), court orders, and service level agreements (SLAs) with partner areas. • Conduct research and identify accredited or occasional providers, ensuring service to beneficiaries and compliance with regulatory or judicial deadlines. • Schedule appointments when necessary to promote the best possible beneficiary experience. • Map providers suitable for occasional care and recommend opportunities to expand the network to the credentialing team. • Negotiate service terms and reimbursement schedules with occasional providers, ensuring technical and financial feasibility for operations. • Record in the CNU system all transactions related to occasional payments, with supporting documentation (reports, quotes, medical orders, invoices, etc.). • Serve as the relationship channel with occasional providers, including those responsible for long-term care (e.g., ASD, oncology, chronic renal conditions, step-down hospitals), monitoring the process through to permanent transition into the accredited network. • Comply with legal and internal requirements related to quality, ANS standards, occupational health and safety, and other organizational guidelines. • Support leadership in carrying out other activities compatible with the scope of the role and with the incumbent’s level of qualification and autonomy.

🎯 Requirements

• Bachelor's degree in Administration, Hospital Management, Nursing, Economics, Law, or related fields. • Postgraduate degree or MBA in Supplementary Health, Health Regulation, Health Management, or Financial Management is desirable. • Proficiency in Microsoft Office (Office Suite).

🏖️ Benefits

• Medical Insurance: Outpatient, hospital and obstetric coverage for you and your legal dependents. • Dental Insurance: Company-subsidized plans covering basic procedures through orthodontics and prosthetics. • Pharmacy Agreement: Access to discounted medications at participating pharmacies with payroll deduction and limits based on salary. • Wellhub (Gympass): Well-being platform with access to gyms and health apps, extendable to up to 3 dependents. • Meal Card: Amount credited for each working day to cover daily meals. • Food Card: Monthly credit to assist with grocery shopping. • Private Pension Plan: Company-sponsored plan to support building financial reserves and future income. • Life Insurance: Coverage for death and disability, providing financial protection for you and your family. • PPR (Profit-Sharing/Performance Bonus Program): Annual reward based on achievement of the cooperative’s collective targets. • Commuter Allowance (Transport Voucher): Available for travel between home and work in on-site or hybrid arrangements. • Parking: Agreements with parking facilities near company locations. • Day Off: One day off granted after your birthday to be used as you prefer. • Family Support: Childcare or nanny allowance for employees with children up to 16 months. • Perks Club: Partnerships and discounts with educational institutions, language schools and leisure providers.